Chapter 26 Health Promotion And Pregnancy Flashcards
What would the nurse expect the patient to report as presumptive signs of pregnancy? Select all that apply.
- Amenorrhea
- Nausea and vomiting
- Breast changes
- Positive home pregnancy test
- Urinary frequency
- Amenorrhea
- Nausea and vomiting
- Breast changes
- Urinary frequency
Rational
- Amenorrhea - This is the absence of menstruation, often one of the first signs of pregnancy.
- Nausea and vomiting - Commonly known as morning sickness, which many pregnant individuals experience.
- Breast changes - These include tenderness, enlargement, or darkening of the areola, which are common in early pregnancy.
- Urinary frequency - This is a common symptom due to hormonal changes and increased blood volume during early pregnancy.
Final Answer: 1, 2, 3, 5
The woman is in the first trimester of pregnancy and tells the nurse that she has morning sickness almost every day. Which intervention would the nurse suggest first?
- Taking an over-the-counter antacid
- Keeping a daily symptom diary
- Drinking a tea made of ginger root
- Nibbling a few soda crackers before rising
- Nibbling a few soda crackers before rising
Rational
- Nibbling on soda crackers before rising is a well-known and safe method to help settle the stomach and reduce morning sickness symptoms.
The woman is in the third trimester of pregnancy and the nurse observes that the woman’s feet and ankles are unusually swollen. What is the most important assessment for the nurse to make?
- Ask the woman if she has been resting and elevating her legs.
- Assess the peripheral pulses and movement of the ankle joints.
- Assess for edema of the face, presacral area, or fingers.
- Ask the woman how much fluid she typical drinks in a day.
- Assess for edema of the face, presacral area, or fingers.
Rational
The most important assessment for the nurse is to check for signs that could indicate preeclampsia. This means assessing for edema in areas other than the feet and ankles, such as the face, presacral area, or fingers, which might suggest systemic involvement.
The health care provider (HCP) tells the nurse that a couple expecting their first child is considering testing to detect chromosomal abnor-malities. Which informational pamphlets is the nurse most likely to prepare? Select all that apply.
- “Amniocentesis Can Reveal Information
About Genetic Factors” - “What an Ultrasound Shows About the Health of Your Baby”
- “Chorionic Villus Sampling to Detect Genetic Disorders of the Fetus”
- “Quadruple Marker Screening: A Low-Risk
Test” - “The Biophysical Profile of You and Your Baby”
- “Nuchal Translucency Screening to Assess for Potential Down Syndrome”
- “Amniocentesis Can Reveal Information
About Genetic Factors” - “Chorionic Villus Sampling to Detect Genetic Disorders of the Fetus”
- “Quadruple Marker Screening: A Low-Risk
Test” - “Nuchal Translucency Screening to Assess for Potential Down Syndrome”
Rational
- Amniocentesis: This procedure can provide information about genetic factors and detect chromosomal abnormalities. It’s relevant for the couple considering testing for such issues.
- Chorionic Villus Sampling (CVS): This test is used to detect genetic disorders in the fetus, making it highly relevant for detecting chromosomal abnormalities.
- Quadruple Marker Screening: This is a screening test that assesses the risk of chromosomal abnormalities such as Down syndrome. It’s considered a low-risk test and is pertinent to the scenario.
- Nuchal Translucency Screening: This test assesses the risk for Down syndrome and other chromosomal abnormalities in the fetus.
The pregnant woman reports blurring and
double vision. Which assessment would the
nurse immediately perform?
- Check the patient’s blood pressure.
- Assess the patient’s visual acuity.
- Auscultate the lungs and count respirations.
- Assess balance and coordination.
- Check the patient’s blood pressure.
Rational
In the scenario provided, the pregnant woman is experiencing blurring and double vision. These symptoms can be indicative of preeclampsia, a serious condition characterized by high blood pressure during pregnancy. Therefore, the most immediate and critical assessment the nurse should perform is to check the patient’s blood pressure. This helps in quickly identifying or ruling out preeclampsia, which requires prompt medical attention to prevent complications for both the mother and the baby.
Which exercise would the pregnant woman be taught to avoid?
- Water exercise due to risk of pool water entering vagina
- Prenatal yoga due to risk of overheating
- Ice hockey due to risk of injury
- Cycling on a stationary bicycle due to risk of falling
- Ice hockey due to risk of injury
Rational
Ice hockey: This is a high-contact sport with a significant risk of injury. Pregnant women are advised to avoid activities with a high risk of falling or abdominal trauma.
- After delivery, the nurse is examining the pla-centa. Which is the most important observation that the nurse would note and document?
- Weight of the placenta
- Presence of the placental barrier
- Appearance of the “Shiny Schultz”
- Intactness of the placenta
- Intactness of the placenta
Rational
When examining the placenta after delivery, the most crucial observation for the nurse is to ensure the placenta is intact. This is because any retained placental fragments in the uterus can lead to complications such as postpartum hemorrhage or infection. While the other observations (weight, presence of the placental barrier, and appearance of the “Shiny Schultz”) can provide useful information, the intactness of the placenta is vital for the immediate health and safety of the mother.
- The nurse is comparing today’s fundal height measurement with the previous recording taken 5 weeks ago. What is the significance of a stable or decreased measurement?
- Possible intrauterine growth restriction
- Possible multifetal gestation
- Possible excessive amniotic fluid
- Expected normal finding
- Possible intrauterine growth restriction
Rational
Possible intrauterine growth restriction: This is the most likely explanation for a stable or decreased fundal height measurement, as it may indicate that the baby is not growing at the expected rate.
The patient had her last menstrual period
(LMP) on August 18, 2021. Using Nägele’s rule, when is the estimated date of birth (EDB)?
May 25 2022
Rational
Given the LMP: August 18, 2021
- Add one year: August 18, 2022
- Subtract three months: May 18, 2022
- Add seven days: May 25, 2022
Thus, the estimated date of birth (EDB) is May 25, 2022.
Define the parity of the pregnant woman using the GTPAL system: She has been pregnant four times, delivered three full-term infants, had no abortions or preterm deliveries, and has three living children.
G4,T3,P0,A0,L3
Rational
- G (Gravida): She has been pregnant four times, so G = 4.
- T (Term births): She delivered three full-term infants, so T = 3.
- P (Preterm births): She had no preterm deliveries, so P = 0.
- A (Abortions): She had no abortions, so A = 0.
- L (Living children): She has three living children, so L = 3.
Putting it all together, the GTPAL notation for her is 4-3-0-0-3.
The nurse is taking a prenatal history. The patient is currently pregnant. She had one full-term delivery, one baby born at 26 weeks who did not survive, and one abortion. How would the nurse note the patient’s obstetric history using the GTPAL system?
- G3 P1111
- G4 P1111
- G4 P2012
- G3 P3011
- G4 P1111
Rational
- The patient is currently pregnant, so Gravida (G) is 4.
- She had one full-term delivery, so Term (T) is 1.
- She had one preterm delivery (at 26 weeks), so Preterm (P) is 1.
- She had one abortion, so Abortions (A) is 1.
- She has one living child from the full-term delivery, so Living (L) is 1.
Putting it all together in the GTPAL format: G4 T1 P1 A1 L1.
